Diagnosis

Acupuncture Allergies Alzheimer's Disease Androgen Anxiety Disorders Asthma Atherosclerosis Attention Deficit Hyperactivity Disorder Bacterial Vaginosis Biofeedback Bipolar Disorder Birth Control Pills Blood Donation and Transfusion Breast Augmentation and Reduction Breast Cancer Breastfeeding Breast Reconstruction Caregiving Cervical Cancer Chiropractic Chlamydia Cholesterol Chronic Fatigue Syndrome Clinical Trials Colon Cancer Contraception Depression Diabetes Dry Eye Syndrome Eating Disorders Endometriosis Epilepsy Estrogen Fibroids Fibromyalgia Fitness Flu/Colds Gastroesophageal Reflux Disease (GERD) Genetic Testing Genital Herpes Glaucoma Gonorrhea Health Insurance Heart Disease Hepatitis High Blood Pressure HIV/AIDS Homeopathy Human Papillomavirus Hypnosis Hysterectomy Incontinence Infertility Irritable Bowel Syndrome Legal Health Tools Liposuction Lung Cancer Lupus Macular Degeneration Medication Safety Menopause Menstrual Disorders Metabolic Syndrome Migraine Multiple Sclerosis Naturopathy Nonsurgical Aesthetic Procedures Nutrition Obesity Ocular Allergies Oral Health Osteoarthritis Osteopathic Medicine Osteoporosis Ovarian Cancer Overactive Bladder Pain Management Pelvic Organ Prolapse Pelvic Pain Peripheral Arterial Disease Polycystic Ovary Syndrome Pregnancy Premenstrual Syndrome Preparing for Surgery Progesterone Rheumatoid Arthritis Schizophrenia Scleroderma Sexual Dysfunction Sinusitis Sjogren's Syndrome Skin Cancer Skin Health Sleep Disorders Smoking Stress Stroke Substance Abuse Tai Chi Teen Health Thyroid Disorders Trichomoniasis Urinary Tract Conditions Urinary Tract Infection Uterine Cancer Varicose Veins Violence Against Women Vulvodynia Weight Management Yeast Infections Yoga

Unlike major depression, which can occur at any age, bipolar disorder, also known as manic depression, generally strikes in late adolescence or early adulthood, generally before the age of 35, and usually continues throughout a person's life. However, some people develop their first symptoms in childhood and others don't develop them until later in life.

Researchers theorize that there are a number of contributing factors for why and how someone develops bipolar disorder, including a genetic predisposition, environmental influences and brain chemistry.

According to the National Institute of Mental Health (NIMH), close relatives of people suffering from bipolar illness are 10 to 20 times more likely to develop either depression or bipolar disorder than the general population. It is important to note, however, that not everybody with a family history develops the illness. No one gene has been identified for the disorder, but it appears likely that many different genes act together and in combination with other factors in the person or the person's environment, to cause bipolar disorder.

Studies of identical twins who share the same genes show that a person who has an identical twin with bipolar disorder is more likely to develop the disorder than someone who has a sibling with the illness, indicating that genes are definitely involved. However, an individual who has a twin with bipolar disorder will not always develop the illness, indicating that genes and other factors both play a role.

Studies suggest that stress, difficulty at work or interpersonal relationships may trigger episodes in those with bipolar disorder, particularly if the stress causes loss of sleep. The theory is that stress and/or loss of sleep precipitates changes in brain chemistry in susceptible people.

Behaviors and moods common to bipolar disorder may initially be attributed to other medical problems, or other mental illnesses, which can delay an accurate diagnosis and appropriate treatment. For example, many people with bipolar disorder are misdiagnosed with major depression. In addition, alcohol and drug abuse and/or difficulties with work and school performance may be identified, but their underlying cause—bipolar disorder—may not be diagnosed. However, the disorder is not difficult to diagnose by a well-trained clinician.

Bipolar disorder is diagnosed based on an evaluation of symptoms, the course of the illness and family history. Physical tests, such as a blood test or brain scan, cannot conclusively identify the illness, although progress is being made in these areas. For example, brain-imaging studies using magnetic resonance imaging (MRI), positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) procedures allow researchers to take pictures of the brain to examine its structure and activity. These noninvasive techniques are beginning to help scientists learn what goes wrong in the brain to produce bipolar disorder as well as other mental illnesses.

Symptoms

The symptoms of bipolar disorder fall into several categories: depression, mania and mixed state type of episodes (in mixed episodes, symptoms of both depression and mania are present at the same time). In addition, people experiencing any of these types of mood episodes may experience psychosis, which is a serious inability to think and perceive clearly, or losing touch with reality. If you or a family member experiences any of these symptoms, you should discuss them with a health care professional and request a thorough evaluation, which should include a physical checkup and a family health history.

The symptoms of depression include:

• constant or persistent sadness

• loss of pleasure and interest in activities that were once fun, including sex

• significant change in appetite or weight (either increase or decrease)

• restlessness or agitation

• irritability or excessive crying

• change in sleep patterns, either oversleeping or insomnia

• lack of energy, feeling slowed down mentally and physically

• feelings of guilt, worthlessness, helplessness, hopelessness

• persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain

• difficulty thinking or concentrating

• recurring thoughts of death or suicide

The symptoms of mania include:

• persistent and abnormally elevated mood (euphoria)

• irritability

• overly inflated self-esteem or feelings of importance

• a decreased need for sleep

• increased talkativeness

• racing thoughts

• increased activity, including sexual activity

• distractibility

• increased energy and/or physical agitation

• excessive involvement in risky behaviors, such as spending money irresponsibly

• poor judgment

• inappropriate social behavior

Significant disruption in your sleep-wake cycle is an early warning sign of an impending episode. Controlling your sleep-wake cycle and maintaining a regular pattern is critical to avoid making the illness worse.

Other symptoms of manic depression include psychosis, which involves hallucinations and delusions (falsely believing in something with conviction, despite proof or evidence to the contrary).

Mixed state episodes include symptoms of both depression and mania, often including agitation, trouble sleeping, and change in appetite, psychosis and thoughts of suicide.

Symptoms of mania, depression or mixed state are episodic and typically recur. Episodes may become more frequent with age. These episodes, especially early in the course of the illness, are separated by periods of wellness, when someone suffers few or no symptoms.

Women with bipolar syndrome are more likely to experience psychosis and manic episodes during pregnancy and after giving birth. According to the National Alliance on Mental Illness, pregnant women and new mothers with bipolar disorder have seven times the risk of hospitalization and two times the risk of a recurrent episode compared to women who are not pregnant or who have not recently delivered.

The combinations and severity of symptoms vary from person to person. Some people have severe manic episodes in which they feel out of control, have tremendous difficulty functioning and severe psychosis. Other people have milder "hypomanic" episodes that include increased energy, euphoria and irritability. Some suffer completely incapacitating periods of depression and are unable to function within their normal daily routine. Hospitalization is sometimes necessary to treat severe episodes of mania or depression.

If you have bipolar disorder, you may have difficulty acknowledging your mood swings even if family and friends tell you about these behaviors.

During a manic episode, you might abuse alcohol, schedule too many events or meetings for one day, drive recklessly, go on a spending spree, make unwise or risky business decisions or be unusually promiscuous sexually. Untreated, the manic phase can last three months or longer. As it fades, a period of normal mood and behavior may occur. Sometimes the depressive phase of the illness then sets in, but another manic episode could also follow.

When you're experiencing a depressed episode, you might lose complete interest in everything you used to enjoy, not be able to stop crying, feel completely hopeless and contemplate suicide. In some people, depression occurs immediately after a manic episode or within the next few months. But with others, there is a long interval before the next manic or depressive episode. The depressive phase has the same symptoms as major depression (also called "unipolar" depression).

People with bipolar disorder may have abnormal thyroid gland function. Because too much or too little thyroid hormone alone can lead to mood and energy changes, it is important that your health care professional closely monitor your thyroid levels. Additionally, if you're treated with lithium that may also cause low thyroid levels.